Ultrahypofractionation and Normal Tissue Toxicity

Purpose

This research is being done to see if proton beam radiation therapy (PBT) results in fewer changes to a participant's heart measured with MRI-imaging than conventional or "photon" radiation therapy (XRT) for participants with non-metastatic left sided breast cancer. The names of the two study groups in this research study are: - Proton Radiation Therapy (PBT) - Conventional or "Photon" Radiation Therapy (XRT)

Conditions

  • Breast Cancer
  • Breast Cancer Female
  • Breast Cancer Stage II
  • Breast Cancer Stage III
  • Myocardial Fibrosis

Eligibility

Eligible Ages
Over 18 Years
Eligible Genders
Female
Accepts Healthy Volunteers
No

Inclusion Criteria

  • ≥18 years of age - Non-metastatic Breast Cancer patients who are scheduled to receive conventional left-sided or bilateral breast/chest wall RT inclusive of treatment to the internal mammary lymph nodes (IMNs) - Prior chemotherapy is permitted - Ability to understand and the willingness to sign a written informed consent document - No contraindication to MRI - Patients with right-sided breast cancer or patients with left-sided patients not requiring treatment to the IMNs, but where cardiac anatomy is determined to be unfavorable by the study PI, will be considered eligible.

Exclusion Criteria

  • Person who is pregnant or breastfeeding. - Patients receiving any other investigational agent will not be excluded from study eligibility, unless the patient is already enrolled in an interventional study evaluating cardiac toxicity. No cytotoxic therapy or radiotherapy may be used during radiation therapy. - Contra-indication to gadolinium contrast (e.g., chronic kidney disease) - Contra-indication to radiotherapy (e.g., scleroderma, p53 mutation)

Study Design

Phase
N/A
Study Type
Interventional
Allocation
Randomized
Intervention Model
Parallel Assignment
Primary Purpose
Treatment
Masking
None (Open Label)

Arm Groups

ArmDescriptionAssigned Intervention
Experimental
Accelerated Proton Beam Radiation Therapy (PBT) Group
Participants will be randomized 1:1 to XRT group and stratified by receipt of chemotherapy and cardiac risk factors and will complete: - Cardiac MRI and blood tests within 1 month prior to start of radiation therapy. - Radiation therapy 1x daily for 5 days over 1 week. - End of radiation therapy visit with blood tests. - 6 month follow up visit with cardiac MRI, blood tests, questionnaires, and photographic imaging. - 12 month follow up visit with questionnaires and photographic imaging.
  • Radiation: Accelerated Proton Beam Radiation Therapy (PBT)
    per protocol
Experimental
Accelerated Photon Radiation Therapy (XRT) Group
Participants will be randomized 1:1 to XRT group and stratified by receipt of chemotherapy and cardiac risk factors and will complete: - Cardiac MRI and blood tests within 1 month prior to start of radiation therapy. - Radiation therapy 1x daily for 5 days over 1 week. - End of radiation therapy visit with blood tests. - 6 month follow up visit with cardiac MRI, blood tests, questionnaires, and photographic imaging. - 12 month follow up visit with questionnaires and photographic imaging.
  • Radiation: Accelerated Photon Radiation Therapy (XRT)
    per protocol

Recruiting Locations

Massachusetts General Hospital Cancer Center
Boston, Massachusetts 02215
Contact:
Rachel Jimenez, MD
617-726-8651
RBJIMENEZ@PARTNERS.ORG

More Details

Status
Recruiting
Sponsor
Massachusetts General Hospital

Study Contact

Rachel Jimenez, MD
617-726-8651
RBJIMENEZ@PARTNERS.ORG

Detailed Description

This is a randomized phase II trial comparing participants with stage II-III breast cancer treated with accelerated Proton Beam Radiation Therapy (PBT) versus accelerated conventional photon radiation therapy (XRT) inclusive of the regional lymph nodes. Participants will be randomized into one of two study groups: proton beam radiation therapy versus photon radiation therapy. Randomization means that participants are put into a group by chance. Study procedures includes screening for eligibility, study treatment visits, Cardiac Magnetic Resonance Imaging (MRI), blood tests, and questionnaires. The National Cancer Institute, American Society of Clinical Oncology, and Claflin Grant are supporting this research by providing funding for the research study.